Mr. Martin Varley:

Yes. It is one of the main issues causing difficulty for consultants, namely, that we cannot recruit and replace in a timely fashion. If we are filling posts now, we are, in effect, filling gaps with people who are not meeting the HSE standards or the Medical Council requirements, as we see them.

Deputy Durkan raised questions about the recruitment crisis. While there were always challenges in recruiting in previous decades, in the last decade the scale of the challenge has become far more prolonged and deep to the extent that a quarter of the posts advertised the year before last had no applicants and possibly another quarter had one applicant, so, in effect, for half of the advertised posts, there was no competition. On balance, we would be talking about the rest of the posts having, say, two applicants and let us not forget there could be five or six consultant anaesthetist posts advertised at any one time so, in fact, we could be seeing similar people applying for similar posts. The scale of competition is much reduced compared with the position prior to 2008. This comes back to the absolute breach of trust and the failure to honour basic contract terms, which is very unfortunate.

Another development we note is the increase in the number of consultants resigning from their posts to practise in private hospitals or to practise abroad, which is a new and increasing phenomenon. Again, I think this goes back to the breach of trust and also the lack of resources to provide timely care to patients. The third development we note in recent times is that more and more consultants are considering working part-time because of the stress and lack of resources, and, no doubt, also because of the breach of contract. Unfortunately, we are seeing a growing problem that is beginning to mushroom out into the system.

I do not have the luxury of seeing the most recent data circulated by the HSE but we were provided with data on where these posts were back in October. All I would say is that this is becoming more and more extensive and, at that time, it was affecting posts in 15 specialties throughout 15 acute hospitals and ten mental health services. In fact, the list I have seen suggests it is also impacting tertiary hospitals and cancer centres. While I am not sure what is in the current data, it is becoming quite extensive, which is a concern on several fronts.